Drug addiction involves compulsive seeking to use an addictive substance, regardless of the potentially negative social, psychological, and physical consequences. An estimated 19.5 million Americans use illicit drugs and, according to National Drug control Policy director John Walters, 3.6 million of these are teenagers. While not everyone who uses drugs becomes addicted, many people do. As many as 19,000 people die of drug-related causes each year.

What is a drug?

A drug is any chemical that produces a therapeutic or non-therapeutic effect in the body. Many prescription drugs that produce therapeutic effects may also cause non-therapeutic effects if taken in excess and/or without a specific prescription.

Drugs are categorized into seven different types:

Cannabinoids (hashish and marijuana)

Depressants (such as Nembutol, Xanax, and Qualudes

Dissociative Anesthetics (such as PCP)

Hallucinogens (such as LSD and mescaline)

Stimulants (such as amphetamines and cocaine)

Other compounds (such as steroids and inhalants)

Opioids and Morphine derivatives (such as heroin, opium, and some prescription drugs, including Vicodin).

There are literally hundreds of commonly abused drugs readily available to users. The National Institute on Drug Abuse has compiled an extensive table identifying about 50 commonly abused drugs with useful information that includes:

Category

Examples of commercial and street names

How administered (orally or by needle)

Intoxication effects

Potential Health consequences

The table is by no means all-inclusive of currently available narcotics and otherwise illicit drugs, and experts warn that additional ones become available every day.

What are the signs and symptoms of drug abuse?

With the extent and diversity of available substances, the signs and symptoms of drug abuse vary widely. For example, whereas the primary initial physical signs of LSD are hallucinations, the signs for opioids such as Vicodin are euphoria and drowsiness.

Focus Adolescent Services has developed a useful chart of warning signs for teen substance abuse based on changes and trends rather than just physical symptoms:

Social ProblemsNew anti-social friends, problems with the law, changes to less conventional styles in dress and music

What are the effects of drug abuse?

In addition to these lifestyle changes, drug abuse can have serious short- and long-term medical effects, among which are:

dangerously increased heart rate and blood pressure

hepatitis or AIDS through shared needles

violent, erratic, or paranoid behavior and hallucinations

clinical depression

sleeplessness and tremors

liver, lung, and kidney impairment

sudden death (from misuse of inhalants, or from heart attack or stroke).

Most of the most serious medical effects result if and when a drug abuser becomes addicted to a drug or drugs. The sequence of events often is as follows:

S/he experiments with a popular addictive drug.

S/he enjoys the euphoria and repeats the use again and again.

S/he may try to stop using the drug.

S/he can't stop; the brain demands the drug.

The drug use is compulsive; s/he is addicted.

What causes drug addiction?

People use drugs for many reasons, such as:

curiosity or experimentation

peer pressure or desire to be part of a group

a sense of relaxation and pleasurable euphoria

numbing effect that helps to ease physical or emotional pain.

It is not likely that anyone begins using a drug with the intention of becoming addicted. However, the very qualities that lead to use are in themselves addictive. In addition, addiction results in painful withdrawal symptoms when stopped suddenly, providing another incentive to continue using.

The medical causes of drug addiction are not fully known. Researchers can only state with assurance that the repeated use of addictive drugs can bring about dramatic changes in both the structure and the function of the brain in destructive ways that can result in compulsive drug use.

The most recent scientific research speculates that some people may be more prone to drug addiction than others and that there may be genes that predispose certain people to addiction. However, an even more important factor in the cause of addiction may be social circumstances, which include:

low self-esteem

emotional distress

patterns of use in the addict's family or subculture

peer pressure

advertising or media influence

easy access.

What should you do if you suspect drug abuse or addiction in yourself or others?

Both drug abuse and drug addiction can be successfully treated, but the treatment process is much easier and much more likely to be successful if it is started early. So don't delay. You can and should intercede as soon as you suspect drug abuse.

To start the process, you can get information leading to help for yourself or a loved one from your physician and via the Internet. Many resources appear in the listings below, including:

National and state organizations specializing in drug abuse treatment

Treatment centers

Referral centers

Hot lines

Moreover, most local communities have their own resources that are available to you. Some common sources that are often listed in the local telephone book are

Community drug hotlines

Local emergency health clinics or community treatment services

City/local health departments

Hospitals

Local support chapters or groups.

Although you may be hesitant to do this research and seek help, it will almost surely lead you to treatment tailored to the drug abuse problems facing you or your friend or your loved one who needs help. Today's treatment programs offer organized and structured services with individual, group, and family therapy for people with drug abuse problems. Research shows that when appropriate treatment is given and when a prescribed program is followed, treatment can work.

How is drug addiction treated?

Treatment for people who abuse drugs but are not yet addicted to them most often consists of behavioral therapies, such as:

psychotherapy,

counseling,

support groups, or

family therapy.

Drug addiction is also a treatable disorder, but treating drug-addicted people often requires a combination of behavioral therapies and medications. The primary medically assisted withdrawal method for narcotic addiction is to switch the patient to a comparable drug that produces milder withdrawal symptoms, and then gradually taper off the substitute medication.

Medications for treating drug addiction

Medications such as methadone or LAAM (levo-alpha-acetyl-methadol) are effective in suppressing the withdrawal symptoms and drug craving associated with narcotic addiction, thus reducing illicit drug use and improving the chances of the individual remaining in treatment.

Once a patient goes through withdrawal, there is still considerable risk of relapse. A great deal of research is being done to find medications that can block drug craving and treat other factors that cause a return to drugs.

There are currently no medications approved by the Food and Drug Administration (FDA) for treating addiction to the following drugs:

cocaine

LSD

PCP

marijuana

methamphetamine and other stimulants

inhalants

anabolic steroids.

There are medications, however, for treating the adverse health effects of these drugs, such as seizures or psychotic reactions, and for overdoses from opiates.

Finding an appropriate treatment program

The National Institute on Drug Abuse stresses that while the ultimate goal of all drug abuse treatment is to enable the abuser or addict to achieve lasting abstinence, there are important immediate goals as well:

to reduce drug use,

improve the patient's ability to function, and

minimize the medical and social complications of drug abuse.

As listed in the searchable Substance Abuse Treatment Facility Locator (see resources below), there are 11,000 addiction treatment programs in the U.S. including:

In-patient residential treatment centers

In-patient hospital programs, and

Outpatient treatment centers.

Inpatient and outpatient facilities have comparable success rates. The choice of institutional treatment program can be dictated by any of a number of factors, such as:

severity of dependence

availability of facilities

insurance coverage or financial aid

need for detoxification, methadone, or long-term treatment

factors such as age, pregnancy, young children, or need for other medical treatment

need for treatment in language other than English

Among the different types of treatment programs are:

Outpatient drug-free treatment programs, which do not include medications and encompass a wide variety of programs for abusers who visit a clinic at regular intervals. Most of the programs involve individual or group counseling.

Therapeutic communities (TCs), which are highly structured programs in which patients stay at a residence, typically for 6 to 12 months. Patients in TCs include those with relatively long histories of drug dependence, involvement in serious criminal activities, and seriously impaired social functioning.

Short-term residential programs, often referred to as chemical dependency units, involve a 3- to 6-week inpatient treatment phase followed by extended outpatient therapy or participation in 12-step self-help groups, such as Narcotics Anonymous or Cocaine Anonymous.

Long-term residential programs involve a stay for detoxification, short-term (a few days to a few weeks), or longer term treatment (a few months to a year or more). These facilities provide a structured environment, often based on the 12-step approach, and include drug education and different types of therapy (group, individual, and sometimes family or couples therapy).

Methadone maintenance programs for heroin addicts, which are usually more successful at retaining clients with opiate dependence than are therapeutic communities ? which in turn are more successful than outpatient programs that provide only psychotherapy and counseling.

The NIDC has concluded that, in general, the more treatment given, the better the results. Specifically:

Patients who stay in treatment longer than three months usually have better outcomes than those who stay less time.

Patients who go through medically assisted withdrawal to minimize discomfort but do not receive any further treatment, perform about the same in terms of their drug use as those who were never treated.

Over the last 25 years, studies have shown that treatment works to reduce drug intake and crimes committed by drug-dependent people.

Researchers also have found that drug abusers who have been through treatment are more likely to have jobs.